丙泊酚联合芬太尼用于无痛人工流产的麻醉效果观察

Observation on anesthesia effects of propofol and fentanyl used in painless induced abortion

目的探讨丙泊酚联合芬太尼用于无痛人工流产中的麻醉效果。方法选取本院2009年1月～2011年1月自愿要求行无痛人工流产术的孕妇80例作为观察对象,全部患者随机分为A组和B组各40例。A组患者于术前30min肌注0.5mg阿托品,进手术室后取膀胱截石位,消毒和铺巾,建立静脉通路,并在给药前鼻导管吸氧以保持呼吸道畅通。然后缓慢静注2.0mg/kg丙泊酚和芬太尼0.05mg,达到镇静麻醉效果后,待睫毛反射消失时即可进行手术。B组患者静注2.0mg/kg丙泊酚后,待麻醉后即可开始手术。结果 A组的镇痛效果明显优于B组,差异有统计学意义(P<0.05)。A组患者的丙泊酚用量明显少于B组,差异有统计学意义(P<0.05)。A组无一例发生人工流产综合征及宫颈松弛,而A组术中及术后发生出血的例数也明显少于B组,差异有统计学意义(P<0.05)。结论丙泊酚联合芬太尼用于无痛人工流产中的麻醉效果确切,镇痛效果明显,副反应少,麻醉诱导和苏醒加迅速,值得广泛推广和应用。

Objective To investigate anesthesia effects of propofol and fentanyl used in painless induced abortion. Methods Eighty pregnant patients were chosen as participants from January 2009 to January 2011 and divided into groups of A and B on average. Group A was given intramuscular injection of 0.5 mg atropine within 30 minutes before operation and patients took lithotomy position in operation room, disinfected and draped, intravenous access established and oxygen uptake were given through nasal catheter to maintain respiratory tract unobstructed before administration, then 2.0 mg/kg propofol and 0.05 mg fentanyl were infused via vein slowly, surgery was performed when eyelash reflex lost after anesthesia effect was reached. Group B was injected with 2.0 mg/kg propofol intravenously and surgery was performed after anesthesia. Re- suits Analgesic effect of group A was obviously superior to that of group B with statistical meaning （P 〈 0.05）. Propofol consumption of group A was lower than that of group B with statistical meaning （P 〈 0.05）. No cases in group A appeared abortion syndrome, cervix laxation and cases of group A was less than group B in hemorrhage during and after operation with statistical meaning （P 〈 0.05）. Conclusion Propofol combined with fentanyl used in painless induced abortion shows definite anesthesia effect and remarkable analgesic effect with less adverse reaction, rapid induction of anesthesia and recovery.